Immunomodulatory Effects of Fractional CO2 Laser and Narrowband UVB in Stable Non-Segmental Vitiligo
- 1Clinic and Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, School of Medicine, University Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
- 2Department of Plant Breeding and Bioresource Engineering, University of Warmia and Mazury, Plac Łódzki 3/422, 10-727 Olsztyn, Poland
Abstract
Stable non-segmental vitiligo is sustained by persistent autoimmune responses involving tissue-resident memory T (TRM) cells, impaired regulatory T-cell (Treg) function, and chronic cytokine-mediated inflammation. Although fractional carbon dioxide (CO2) laser and narrowband ultraviolet B (NB-UVB) phototherapy are widely used to induce repigmentation, their immunomodulatory mechanisms remain incompletely understood. In this prospective, non-randomized exploratory study, 19 patients with stable non-segmental vitiligo received either monthly fractional CO2 laser monotherapy or fractional CO2 laser combined with NB-UVB phototherapy for 6 months. Serum IL-15 and IL-17A concentrations were quantified by ELISA at baseline, 3 months, and 6 months. Double immunofluorescence was performed to evaluate cutaneous TRM- and Treg-associated markers (CD4, CD8, CD25, CD49a, CD69, CD103, FOXP3) together with melanocyte-associated markers (MITF and c-KIT). Longitudinal differences between treatment groups were assessed using linear mixed-effects models with treatment-by-time interactions. Serum IL-15 and IL-17A concentrations decreased significantly over time in both treatment groups. At 6 months, IL-15 concentrations did not differ significantly from those in healthy controls in either group, whereas IL-17A concentrations did not differ significantly from healthy-control values in the fractional CO2 laser monotherapy group but remained significantly higher in the combination-treatment group. Cutaneous analyses demonstrated longitudinal changes in selected TRM- and Treg-associated markers and melanocyte-associated markers, with MITF showing the most pronounced increase. Several cutaneous immune markers remained significantly different from healthy-control values after 6 months. No statistically significant treatment-by-time interactions were detected for IL-15, IL-17A, or the evaluated dermal and epidermal markers. Fractional CO2 laser monotherapy and fractional CO2 laser combined with NB-UVB were both associated with longitudinal changes in circulating inflammatory cytokines and selected cutaneous immune- and melanocyte-associated markers in patients with stable non-segmental vitiligo. Persistent abnormalities in several cutaneous immune markers suggest that treatment did not fully restore the cutaneous immune-marker profile within the 6-month observation period. Given the small sample size and non-randomized exploratory design, the absence of statistically significant treatment-by-time interactions should not be interpreted as evidence of therapeutic equivalence, non-inferiority, or absence of an additional effect of NB-UVB.
Related
- Proteomic analysis of non-segmental vitiligo identifies immune- and keratinocyte-associated protein alterations.
- Efficacy and safety of upadacitinib in adults and adolescents for treatment of non-segmental vitiligo (Viti-Up): results of two phase 3 randomised controlled studies
- Economic burden of immune-mediated and psychiatric comorbidities in patients with newly diagnosed vitiligo
- The Safety of Melasma Treatment in Vitiligo Patients: An International E‐Delphi Study
- Vitiligo and Its Mimics in Childhood: A Diagnostic Framework for Hypopigmented Disorders.
BibTeX
@article{fraczek2026immunomodulatory,
title = {{Immunomodulatory Effects of Fractional CO2 Laser and Narrowband UVB in Stable Non-Segmental Vitiligo}},
author = {Alicja Frączek and Joanna Czerwińska and Dariusz Załuski and Agnieszka Owczarczyk-Saczonek},
journal = {International Journal of Molecular Sciences},
year = {2026},
month = oct,
doi = {10.3390/ijms27209076},
url = {https://www.mdpi.com/1422-0067/27/20/9076},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Immunomodulatory Effects of Fractional CO2 Laser and Narrowband UVB in Stable Non-Segmental Vitiligo
AU - Alicja Frączek
AU - Joanna Czerwińska
AU - Dariusz Załuski
AU - Agnieszka Owczarczyk-Saczonek
PY - 2026
DA - 2026/10/01
JO - International Journal of Molecular Sciences
DO - 10.3390/ijms27209076
UR - https://www.mdpi.com/1422-0067/27/20/9076
AB - Stable non-segmental vitiligo is sustained by persistent autoimmune responses involving tissue-resident memory T (TRM) cells, impaired regulatory T-cell (Treg) function, and chronic cytokine-mediated inflammation. Although fractional carbon dioxide (CO2) laser and narrowband ultraviolet B (NB-UVB) phototherapy are widely used to induce repigmentation, their immunomodulatory mechanisms remain incompletely understood. In this prospective, non-randomized exploratory study, 19 patients with stable non-segmental vitiligo received either monthly fractional CO2 laser monotherapy or fractional CO2 laser combined with NB-UVB phototherapy for 6 months. Serum IL-15 and IL-17A concentrations were quantified by ELISA at baseline, 3 months, and 6 months. Double immunofluorescence was performed to evaluate cutaneous TRM- and Treg-associated markers (CD4, CD8, CD25, CD49a, CD69, CD103, FOXP3) together with melanocyte-associated markers (MITF and c-KIT). Longitudinal differences between treatment groups were assessed using linear mixed-effects models with treatment-by-time interactions. Serum IL-15 and IL-17A concentrations decreased significantly over time in both treatment groups. At 6 months, IL-15 concentrations did not differ significantly from those in healthy controls in either group, whereas IL-17A concentrations did not differ significantly from healthy-control values in the fractional CO2 laser monotherapy group but remained significantly higher in the combination-treatment group. Cutaneous analyses demonstrated longitudinal changes in selected TRM- and Treg-associated markers and melanocyte-associated markers, with MITF showing the most pronounced increase. Several cutaneous immune markers remained significantly different from healthy-control values after 6 months. No statistically significant treatment-by-time interactions were detected for IL-15, IL-17A, or the evaluated dermal and epidermal markers. Fractional CO2 laser monotherapy and fractional CO2 laser combined with NB-UVB were both associated with longitudinal changes in circulating inflammatory cytokines and selected cutaneous immune- and melanocyte-associated markers in patients with stable non-segmental vitiligo. Persistent abnormalities in several cutaneous immune markers suggest that treatment did not fully restore the cutaneous immune-marker profile within the 6-month observation period. Given the small sample size and non-randomized exploratory design, the absence of statistically significant treatment-by-time interactions should not be interpreted as evidence of therapeutic equivalence, non-inferiority, or absence of an additional effect of NB-UVB.
SN - 1422-0067
ER -